Communicable disease

1. TYPHOID

2. TYPHOID FEVER OR ENTERIC FEVER
• Acute bacterial systemic infection caused by
Salmonella typhi
• Causative agent - Salmonella typhi
• Mode of transmission – feco-oral route
• Incubation period – 10-14 days

3. PATHOLOGY
Organism proliferates in the lymphoid tissue of
intestines mainly in ileum
Payers patches become swollen and necrosed with
ulceration which may lead to hemorrhage or
perforation
Bacilli enter blood stream through intestinal
lymphoid tissue and infect liver with focal necrosis
Infection leads to enlargement & congestion of
spleen
Destruction of bacilli in the reticuloendothelial cells
promotes release of endotoxin which causes
toxemia and involvement of vital organs

4. CLINICAL MANIFESTATIONS
• Rapid rise of temperature
• Extreme malaise, Loss of appetite
• Headache, Vomiting, Coated tongue
• Abdominal pain and distention
• Diarrhea, palpable spleen and liver
• Typhoid rash as macular red rose spots
• Respiratory infections, convulsion, anaemia
• Jaundice, enlargement of liver

5. DIAGNOSIS
• CBC - low WBC, low eosinophil
• Blood culture
• Widal test
• Bone marrow culture
• Stool and urine culture
• ELISA test, co-agglutination test

6. MANAGEMENT
• Chloramphenicol 50-100 mg/kg/d
• Ampicillin, amoxicillin, clotrimoxazole
• Cephalosporins
• Corticosteroids
• Antipyretics, IVF, fluid intake
• Blood transfusion if perforation and hemorrhage
• Nutrition, bed rest, hygiene
• Isolation

7. PREVENTION
• Good sanitation and immunization
• Isolation of patient
• Hygienic disposal of stool and urine of infected
person
• Disinfection of contaminated articles
• Handwashing

8. COMPLICATION
• Abdominal – intestinal perforation, GI bleeding,
hepatitis, UTI, AGE, fatty liver, pancreatitis
• Neurological – encephalopathy, meningitis,
hemiplegia, GBS, psychiatric problems, cranial
nerve involvement
• Hematologic - hemolytic anemia, bonmarrow
depression
• Cardio – myocarditis, pericarditis, endocarditis,
• Respiratory – pneumonia, bronchitis, empyema,
pulmonary infarction, pleurisy